Concluded Case

Patient by male ,50 years ,c/o left side of face swelling, extending anteriorly up to angle of mandible ,posteriorly beyond the sternoglydomastoid muscle ,above up to tragus ,below up to middle of above said muscle. Circular swelling ,hard in consistency,, movements well restricted ,on clenching it is more prominent .On flexion of neck swelling more prominent. No significant lymph nodes. oral cavity normal. Diabetic .On treatment under good control. Discuss the Differential diagnosis .

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Concluded answer

This is the case of parotid swelling left side with upper ,horizontal lymph nodes are enlarged .All in a matter of over a month .It was not an sudden enlargement of old existing mass. Oral cavity is normal Mandible is not thickened .Not tender..No fever .No constitutional symptoms. Tonsil normal .Ear canal normal.Vocal cord normal. Patient is referred to Regional cancer institute for their opinion. If he reports to me , let us all see the final diagnosis.

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IT'S A CASE OF .. SWELLING NECK .. ? PAROTID SWELLING .. ? ODONTOGENIC SWELLING .. ? TUBERCULUS LYMPHADENITIS .. ? MALIGNANCY / SECONDARIES .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. HEMOGRAM.. X-RAY STUDY.. USG STUDY..CTCE STUDY.. FNAC ..

Tnx
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D/d Tubercular infection Carcinoma neck Disorders of thyroid gland Hogkins and non hodgkins lymphoma Infectious mononucleosis Sialodenitis Bacterial infection. Advice cbc, Hb1ac, sonography neck, Take an opinion from a ent specialist Check for hoarseness of voice Also ask for personal habits.

Don't think about thyroid in this case.,swelling up to tragus of ear.
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Mostly a parotid swelling, other DD s are TB lymphadenitis, lymphomas, neck secondaries of Nasopjaryngeal carcinoma, tumour of poststyloid compartment of parapharyngeal space, or can even be a neurofibroma or a vagal schwannoma. Advise a USG and an FNAC and proceed

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This is the case of parotid swelling left side with upper ,horizontal lymph nodes are enlarged .All in a matter of over a month .It was not an sudden enlargement of old existing mass. Oral cavity is normal Mandible is not thickened .Not tender..No fever .No constitutional symptoms. Tonsil normal .Ear canal normal.Vocal cord normal. Patient is referred to Regional cancer institute for their opinion. If he reports to me , let us all see the final diagnosis.

DD Parotid swelling Tuberculous lymphadenitis Dental abscess Neck tumor ADV USG with USG guided biopsy for HPE

Ameloblastoma, Odontomas, Parotid swelling Lymphoma, Soft tissue tumor

Cervical lyumphaedinitis dd tb lyumphaedinitis dd cyst dd parotid tumour dd lyumphoma CBC ESR CRP Mt xray chest fnac HP

looks like sial adenitis needs fnac to confirm rule out TB adenitis

Parotid swelling

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